Provider Demographics
NPI:1073848420
Name:CHETTY, URVASHI (DC)
Entity Type:Individual
Prefix:
First Name:URVASHI
Middle Name:
Last Name:CHETTY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 SW 173RD AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-4565
Mailing Address - Country:US
Mailing Address - Phone:503-313-7483
Mailing Address - Fax:
Practice Address - Street 1:1020 SW TAYLOR ST STE 260
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2555
Practice Address - Country:US
Practice Address - Phone:503-313-7483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor